Quiroz-Olguín Gabriela, Gutiérrez-Salmeán Gabriela, Posadas-Calleja Juan G, Padilla-Rubio María F, Serralde-Zúñiga Aurora E
Clinical Nutrition Service, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, Mexico.
Centro de Investigación en Ciencias de la Salud. Facultad de Ciencias de la Universidad Anáhuac México Norte, Huixquilucan, Mexico.
Eur J Clin Nutr. 2021 Nov;75(11):1533-1539. doi: 10.1038/s41430-021-00877-7. Epub 2021 Feb 19.
The intestine plays a fundamental role as a regulator of the mucosal immune response, mostly through the production and secretion of secretory Immunoglobulin A (sIgA) by the gut-associated lymphoid tissue (GALT). Enteral stimulation, a balance between the commensal microbiota and pathogenic microorganisms, in addition to an adequate nutritional status is required for the optimal immune function of the intestine. Fasting subjects or those supported only with parenteral nutrition, show a progressive anatomical and physiological deterioration of the GALT, triggering a series of alterations resulting in a decrease in the intestinal immune response, modification in the type of microbiota, and changes that lead to or aggravate malnutrition. Patients with malnutrition present an increase in the rate of nosocomial infections, hospital length of stay, and mortality. An adequate nutritional assessment at hospital admission and avoiding long periods of fasting are paramount to prevent these unfavorable outcomes. Herein, we present a mini-state of the art review on the role and importance of enteral stimulation by GALT-mediated immune response.
肠道作为黏膜免疫反应的调节者发挥着重要作用，主要是通过肠道相关淋巴组织（GALT）产生和分泌分泌型免疫球蛋白A（sIgA）来实现。肠道刺激，即共生微生物群与病原微生物之间的平衡，以及充足的营养状况，是肠道最佳免疫功能所必需的。禁食的受试者或仅接受肠外营养支持的受试者，其GALT会出现渐进性的解剖和生理退化，引发一系列改变，导致肠道免疫反应降低、微生物群类型改变，以及导致或加重营养不良的变化。营养不良的患者医院感染率、住院时间和死亡率都会增加。入院时进行充分的营养评估并避免长时间禁食对于预防这些不良后果至关重要。在此，我们对GALT介导的免疫反应在肠道刺激中的作用和重要性进行了简要的最新综述。
